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Testosterone injections are the most common form of Testosterone Replacement Therapy (TRT).
There are different types of injectable Testosterone, which have various benefits. These include:
The difference between these types of Testosterone is their ester.
An ester is attached to the Testosterone molecule, and the body has to break it down to utilize the hormone. This creates a timed release, which can help control hormone levels and avoid uncomfortable peaks and lows.
The Testosterone molecule is always the same, but each ester can lead to different results due to the way they are metabolized once injected.
Read on to learn more about Testosterone injection types.
Testosterone Cypionate is a popular ester. It typically has a half-life of 8 days, which means the body metabolizes the ester and the hormone in about a week.
Testosterone Cypionate is usually injected once to twice per week to help maintain stable levels.
100 mg of Testosterone Cypionate typically yields around 68 mg of Testosterone, with the rest being the ester.
Another commonly used ester, Testosterone Propionate is faster acting. It typically peaks in the blood within hours and can be fully metabolized in three days. Injections are typically administered every 2-3 days to maintain consistent levels.
Since it metabolizes quickly and needs to be administered frequently, it’s useful for stabilizing and optimizing blood Testosterone levels in a short time.
100 mg of Testosterone Propionate typically yields around 93 mg of Testosterone.
Testosterone Enanthate is metabolized in roughly 4-5 days. Studies show it can remain in the body in trace amounts for up to two weeks.
Testosterone Enanthate is often injected every 5 days. While each patient responds differently to medication, the starting dose is often 100 to 200 mg injected intramuscularly every 5-7 days.
Testosterone Undecanoate is available as brand name AVEED®. This ester is one of the longest acting, with studies showing that Testosterone levels remained elevated for roughly three months post-injection.
Injections are typically every 30 to 90 days, and protocols vary based on the patient’s response. Because Testosterone Undecanoate is only available as a brand-name medication, it may be cost-prohibitive for many patients.
Compounded ester combinations can offer multiple effects for more balanced levels. For example, a Propionate/Cypionate blend can optimize levels quickly due to the Propionate, while offering more stabilized levels over time due to the longer-acting Cypionate.
Common combinations include:
An aqueous Testosterone suspension doesn’t include an ester. It’s typically injected as an intramuscular injection, and it only remains in the body for a few hours.
This type of injection is painful and doesn’t have a timed release, making it ineffective at balancing levels over time. We don’t typically recommend aqueous Testosterone suspension injections.
For Testosterone Replacement Therapy, timing and frequency of injections are just as important as the ester. The ultimate goal should be to restore total Testosterone to an optimal range, with about 2%-4% free Testosterone in the blood.
Most patients can achieve this using any ester if the injection is timed correctly. Your choice will depend on individual factors like your comfort level with injection frequency, how your body metabolizes Testosterone and esters, how your protocol makes you feel, and whether you experience symptom relief.
It’s important to work with an experienced provider who can guide you through your options and develop a customized plan that works for you.
Your provider should also make adjustments based on your feedback and offer regular follow-up to help you optimize your levels in the long-term.
Defy Medical offers customized Testosterone injection therapy protocols with different esters. As Men’s Health experts, our care team has successfully treated thousands of men and women with hormone restoration.
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